Monday, 7 August 2017

Sugaring the pill

It has been recently reported that moderate alcohol consumption reduces the risk of developing Type 2 diabetes. This is yet another contribution to the huge body of research suggesting that moderate drinking is beneficial to health, and further undermines the Public Health objective of being able to claim that any level of alcohol consumption is harmful.

As those of you who follow me on Twitter or Facebook may be aware, I was diagnosed with Type 2 diabetes earlier this year. Obviously such news takes you back a bit but, given that my father had the condition, and, in hindsight, I recognise that I had been experiencing some of the symptoms, it wasn’t a total bolt from the blue.

Well, Mudgie, you may say, you have spent forty years living on a diet mainly consisting of beer, pork scratchings and pizza, so you shouldn’t be too surprised, and really only have yourself to blame. However, risk factors are not direct causes. General lifestyle factors in society have raised the likelihood of people developing diabetes, plus diagnosis is now more likely than it once was, and people are living longer.

In the past, given that the immediate symptoms can be far from obvious, many people will have gone to their graves without it being spotted. My father wasn’t diagnosed until his late seventies.
Whether you develop it has far more to do with heredity and chance than the actual lifestyle you live, and I know plenty of people who have drunk deeper and gorged more yet have remained immune. While I make no claim to have rigidly adhered to healthy living guidelines, I have for many years tried to make sure my alcohol consumption is kept under control, and have never been more than moderately overweight. Indeed, my current BMI is about 26, which I don’t think is anything to get too worried about.

As the news report indicates, drinking alcohol isn’t incompatible with diabetes, despite what some may imagine. However, obviously a bit of care is needed, and I’ve set myself a target of reducing my consumption by 25% compared with previously. On reflection, I was often going for “oh, let’s just have one more” when it added little to the experience. Over five months, I’ve achieved 23%, which isn’t too bad going. But that doesn’t in the slightest deter me from seeking out new pubs and drinking experiences.

In the past, the view was often taken that people with diabetes should completely avoid certain foods, especially those with a high sugar content. However, the current line is that nothing should be considered completely off limits, and that diabetics should basically just adhere to the dietary recommendations for the general population. But I’m a bit sceptical about that. The key factor triggering diabetes is sugar, and the sugar contained within carbohydrates, while fat, while it may not do you much good overall, has no particular implications. So it might make sense to go easy on bread and cakes, but there’s no problem with milk, butter and cheese. Indeed, in recent decades, the general dietary advice has been to eat a low-fat diet with plenty of wholegrain carbohydrates, which has been accompanied by a marked rise in cases of diabetes.

Not surprisingly, the subject is a magnet for various kinds of dietary cranks and single-issue obsessives, especially the zealots advocating a zero-carbohydrate diet. The forum at diabetes.co.uk is so infested with them as to be virtually unusable. And some people seem to have become “professional diabetics”, endlessly analysing their diet and blood sugar readings.

I certainly take the subject seriously, and I would be a fool not to. But my objective is to aim to manage it with the least amount of intrusion into my daily life, not to allow it to become an all-consuming fixation.

And pork scratchings, which contain no sugar or carbs, are in a sense the ideal diabetic food.

As a total aside, this subject gives an opportunity to listen again to this unforgettable classic of Sixties bubblegum:

I think it's something where individual people's reactions can vary quite significantly, so it's difficult to generalise. I have been taking Metformin for five months and was a given a blood glucose meter at the beginning of May. Initially I had quite a scary HbA1C figure and blood glucose readings, but broadly speaking they've now come down to within the acceptable range.

I've stopped eating chocolate and putting sugar in tea and coffee and on cereals, but otherwise not really made any drastic dietary changes. The one thing that was really spiking it was breakfast, despite only having a small glass of orange juice and a couple of Weetabix, which are about the lowest-sugar cereal around.

I recently completed an “X-Pert” diabetes course, which included a lot of useful information, but involved a commitment of time that would be difficult for anyone in full-time employment. The level of resources devoted to diabetes by the NHS cannot be criticised, for example in the 15-point plan offered to people with the condition. There is, however, a rather stark contrast with the often half-hearted and inconsistent response to depression.

I would be the last person to criticise anyone over their weight, but it has to be said there was a rather Marjorie Dawes-like irony about being lectured about increasing physical activity by one of the two female presenters who would undoubtedly have qualified as clinically obese.

There remains an inconsistency between the dietary information I was given by the GP practice, which states carbohydrates are OK in moderation, but ideally should be of the whole grain variety, and that on the course, which rather stressed overall carb reduction and seemed to argue that all carbs are much of a muchness. I have to say I find it a bit hard to believe that 20g of refined sugar is no worse for you than the same amount of wholegrain cereal.

There was an underlying assumption that people were able to prepare the vast majority of their meals themselves at home, which for anyone who travels a bit and has a social life is a touch unrealistic. On a related theme, I saw an article on a diabetes website entitled “9 ways to enjoy takeaways while staying healthy” that in fact offered recipes for home-cooked alternatives, which is totally missing the point. A bit of sensible advice about how to deal with eating-out scenarios would come in handy.

On a personal note, I recently had a blood test which showed that my HBa1C figure, the key measure of long-term blood glucose level, had come down from a rather alarming 108 at the beginning of March to 36, which is within the “normal” range. Clearly this is good news, although it doesn’t mean that I am in any sense cured or can afford to let up on things. As described in the post, I have made a number of diet and lifestyle changes, which obviously must be working, but I certainly haven’t been taking things to extremes.

Dining out and eating in the real world is a big issue and it's very hard socially to comply with healthy eating regimes,regardless of whether they are for diabetes or not. Of course a big problem is also vast portion side,particularly for older generations who were 'taught'to consume everything on the plate,because of past history of older relatives,and food shortages elsewhere in the world. Leaving quantities of food does appear to be a shameful waste in itself,but portion sides are now so big,you have to leave or overconsume,or not go out.Diabetes wise of course it's all about the rate the sugars feed into the blood stream,the slower the better being the key criteria.Of course for most,if they can afford to dine out,it is culturally a time not to skimp on food,usually after a hard weeks toil.In summary,the advice and resource is very good,and you are right,proportionately much better than mental health support,but that doesn't assist with practical living in the real world often,I agree.

Agreed - portions are often ridiculously big, especially for us old 'uns, and it always looks a bit insulting to the chef if you leave a lot of food on the plate. Added to this (for reasons I won't try to go into here) I'm a rather eccentric and fussy eater, which makes conforming to the "ideal diabetic diet" effectively impossible.

I was diagnosed as diabetic about four years ago and put on a course of pills, one of which made me ill and had to be changed. About two years ago I was in Poland and contracted food poisoning. My wife (who is Polish) took me to a hospital and they did a much more thorough check-up than I have ever had from the NHS. At the end of it, they told me that I was not in fact diabetic after all and advised me to drop the medication, which I did. I wonder if the NHS is over-cautious, or likes to 'big-up' conditions so as to help it press for more money?

It might be worth thinking about what sort of sugar you are using. My father has sought for many years to avoid white sugar in favour of brown, and is still going strong at 92 with no sign of diabetes.

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Salient quotations

"If I see one more politician who voted for the smoking ban crying crocodile tears about the state of the pub industry, I may throw up." (Chris Snowdon)

"The era of big, bossy, state interference, top-down lever pulling is coming to an end." (David Cameron, 2008)

"The trouble with fighting for human freedom is that one spends most of one's time defending scoundrels. For it is against scoundrels that oppressive laws are first aimed, and oppression must be stopped at the beginning if it is to be stopped at all." (H. L. Mencken)

"The final nails have now been hammered into the coffin of the freedom to smoke in enclosed public places. This piece of legislation must be one of the most restrictive, spiteful and socially divisive imposed by any British Government. (Lord Stoddart of Swindon)

"Raising taxes on alcohol to prevent problem drinking is akin to raising the price of gasoline to prevent people from speeding." (Edward Peter Stringham)

"Of all tyrannies a tyranny sincerely exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience." (C. S. Lewis)

"People who deal only in 'craft' beer do not care about some dirty old pub and the dirty old people who are in it and the dirty old community that it holds together." (Boozy Procrastinator)

"There's a saying that, given time, all organisations end up as if they were run by a conspiracy of their foes." (Rhys Jones)

"Life should not be a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside in a cloud of smoke, thoroughly used up, totally worn out, and loudly proclaiming 'Wow! What a Ride!" (Hunter S. Thompson)

"No pleasure is worth giving up for the sake of two more years in a geriatric home at Weston-super-Mare." (Kingsley Amis)

"When you have lost your inns, drown your empty selves,
For you will have lost the last of England." (Hilaire Belloc)

What's this all about?

This is not a beer blog. It's a view of life from the saloon bar, not entirely about the saloon bar - which of course is a metaphorical place as well as a physical one. It is as much about political correctness and the erosion of lifestyle freedom as it is about pubs and beer. And, while I enjoy cask beer, I don't assume that it is the only alcoholic beverage worth consuming.

I'm a non-smoker, but not an antismoker. I believe the owners of private property should be entitled to choose whether or not smoking is permitted on their premises. If any supporter of pubs still thinks the smoking ban was a remotely good idea, just look around at all the pubs that have closed since 1 July 2007. The smoking ban is what prompted the creation of this blog back then and, while it touches on many other topics, it remains essentially its core theme. However, there remains much to be enjoyed and celebrated in pubs despite the effects of the ban.

I condemn drunken driving, but there is no evidence that driving after consuming a small quantity of alcohol is dangerous, and the campaign to discourage driving even within the British legal limit has been a major cause of the decline of the pub trade in recent years. Reducing the current legal limit - a proposal fortunately rejected by the Coalition government - would lead to the closure of thousands more pubs and would not necessarily save a single life. In my view, this is at least as much a threat to pubs as the smoking ban.

As you will probably gather from reading the blog, I live in Stockport, Cheshire, a thriving town which is definitely not part of Manchester and has one of the finest collections of characterful pubs in the country.

The blog is written purely for my own entertainment and to get things off my chest. It walks a tightrope between libertarianism and conservatism. It is nostalgic, idiosyncratic and at times inconsistent. You are welcome to disagree, but if you don't like it, you don't have to read it.

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